Vancomycin Drug Information PDF

Antibiotic with gram-positive T L > spectrum of activity. NSM - Effective in treatment of Nafcillin or Methicillin e - resistant Staphylococcus aureus ( NRSA or MRSA). Alternative to penicillin in patients having history of serious penicillin allergy. Bactericidal for most gram L positive or...

Antibiotic with gram-positive T L > spectrum of activity. NSM - Effective in treatment of Nafcillin or Methicillin e - resistant Staphylococcus aureus ( NRSA or MRSA). Alternative to penicillin in patients having history of serious penicillin allergy. Bactericidal for most gram L positive organisms, except against enterococci. - Synergistic withL Gentamicin against most strains of: Introduction: * -> S.aureus - enterococci. Not an effective agent for gram- X negative bacteria. - Resurgence because of increased prevalence of Nafcillin =>resistant Staphylococcus. Used to treat gastrointestinal overgrowths of gram positive bacteria. - - - &! Poorly absorbed orally Systemic infections- i.v. route or[ intraperitoneally 3 for those patients receiving continuous ambulatory peritoneal dialysis. Normal renal function: 1g ( 10 to 15 mg/kg) administered intravenously - O- over 60 minutes everyL 12 hours. In elderly and patients with diminished renal function doses adjusted Doses: = Not given I/M : Painful and causes local irritation and histamine reaction - ↓ that are less than 40 to 50 mg/L 2 & That results in peak plasma concs. Ideal regimen: Therapeutic and Toxic Plasma concentrations: T Peak concs greater thanL 50 mg/ L associated with ototoxicity. - - Specific peak plasma concs have not ? been correlated withL efficacy. T MIC for sensitive bacteria < 5 mg/L & Limited postantibiotic effect of0.5 to 3 hours L - have high clearances and short half lives Pediatric patients: 2 Their trough concs are frequently well below74 5mg/L Patients requiring monitoring: vein Patients with poor renal-> => function: Greater risk of toxicity inflammation & Phlebitis, histamine reaction: & Side effects : V hypotension - Should be infused slowly over 60 min T L - flushing, & tachycardia, - = head out fast to minimize histamine response - Single agent : low incidence of nephrotoxicityI Combination withaminoglycosides - ↳ to prevent it > * & Incidence as high as 30 % Reason not clear Poorly absorbed after oral administration (<5 %) ⑦ Vancomycin Parenteral or intraperitoneal admin necessary for systemic infections Limited oral availability used advantageously to treat enterocolitis. colon 3 SmallI. inflammation L BIOAVAILABILITY (F): CD treat Clostridium difficile produced pseudomembranous colitis, - Oral vancomycin and t metronidazole used to: by use of& broad spectrum antibiotics - - clinical condition precipitated - 0.5- 1.0 L/kg ( 0.7 L/kg ) [ 7 Age and gender influence distribution = - V(L) in adults ( older than 18 years of age) = 0.17 ( age in years)+ 0.22 ( TBW in kg) + 15 Volume of distribution (v): Two or three compartment model best 00 describes distribution. * In clinical practice, one compartment O model frequently used. T L Eliminated primarily by the renal route. 5% dose is metabolized. e Clearance approximates that of creatinine clearance. S sol C L ↓ - · jo CLEARANCE (Cl): Equations: In patients with hemo or peritoneal dialysis: vancomycin loss should be replaced with[ intermittent i.v. injections. 3 on frequent basis. Or instill directly into the peritoneal space. Wa 5 to 10 hours Half life: In patients with end stage renal disease half life may approachL 7 days. - Patients with normal renal function End stage renal disease Receive drug every 8 to 12 hours => Receive dose once a week & Wide fluctuation suggests monitoring of both peak and trough concn. Steady state trough concs appear to be adequate in most cases. Dosed with an interval of approx.one half - life. Generalrule: TIME TO SAMPLE: For very overweight or underweight patients monitoring both peak and trough concs is advisable, particularly for seriously – ill patients. Follows multicompartment model = Difficult to avoid distribution phase when: If peak levels are to be measured, obtaining peak plasma concs. > O samples should be obtained at least 1 or possibly 2 hours after the end O of infusion period. 1 L and trough concs. in range of 5 to 15 mg/L # > Exhibits conc.- independent killing e *